Sulfato de magnesio antenatal y eliminación tardía de meconio: Estudio multicéntrico / Antenatal magnesium sulphate and delayed passage of meconium: A multicentre study

Introducción: La relación entre sulfato de magnesio (MgSO4) y el retraso en la evacuación de meconio presenta resultados controvertidos en la literatura. Objetivos: Determinar si existe relación entre la administración de MgSO4 a la madre y la eliminación tardía de meconio (ETM) en el neonato y conocer los niveles de magnesio en sangre en estos, con respecto a la dosis acumulada de MgSO4 administrada a la madre. Población y métodos: Estudio descriptivo-analítico, en pacientes ≤ 32 semanas de edad gestacional, con diseño retrospectivo-prospectivo, llevado a cabo en dos hospitales de tercer nivel asistencial. Se definió la ETM como retraso en la evacuación meconial ≥ 48 horas y/o necesidad de estimulación rectal en ≥ 2 ocasiones para realizar deposición y/o retraso ≥ 48 horas entre la primera y segunda deposición. Resultados: Se reclutaron 283 pacientes (204 retrospectiva y 79 prospectivamente), de los cuales 152 (53,7%) presentó ETM. No se encontró relación entre la administración de MgSO4 a la madre, ni la dosis acumulada de MgSO4 en esta, ni los niveles de magnesio en sangre del neonato con la presencia de ETM. La mayor edad gestacional (OR 0,8, IC 0,69-0,93, p = 0,003) resultó factor protector independiente de la ETM y la necesidad de reanimación avanzada (OR 2,24, IC 1,04-4,86, p = 0,04) factor de riesgo. Conclusiones: Los niveles alcanzados de magnesio en sangre del neonato con las dosis de MgSO4 administradas a las madres, no se relacionan con la ETM. La menor edad gestacional y la necesidad de reanimación avanzada predicen mayor riesgo de ETM. (AU)

Introduction: The published evidence on the association between magnesium sulphate (MgSO4) and delayed passage of meconium (DPM) is contradictory. Objectives: To determine whether there is an association between the administration of MgSO4 to the mother and DPM in the neonate, and to analyse serum magnesium levels in neonates in relation to the cumulative dose of MgSO4 administered to the mother. Population and methods: Retrospective and prospective descriptive and analytical study conducted in patients delivered at or before 32 weeks of gestation in 2 tertiary care hospitals. Delayed passage of meconium was defined as failure to pass meconium within 48 hours of birth and/or need for rectal stimulation on 2 or more occasions to pass stool and/or interval of at least 48 hours between the first and second bowel movements. Results: The study included 283 patients (204 retrospectively and 79 prospectively), of who 152 (53.7%) experienced DPM. Delayed passage of meconium was not associated with antenatal MgSO4 administration, the cumulative maternal MgSO4 dose or neonatal serum magnesium levels. Older gestational age (OR, 0.8; confidence interval [CI], 0.69–0.93; P = .003) was an independent protective factor against DPM, while the need for advanced resuscitation (OR, 2.24; CI 1.04–4.86; P = .04) was a risk factor for DPM. Conclusion: The neonatal serum levels of magnesium reached with the doses of MgSO4 administered to mothers were not associated with DPM. Lower gestational age and the need for advanced resuscitation were predictors associated with an increased risk of DPM. (AU)

Antenatal magnesium sulphate and delayed passage of meconium: A multicentre study.

INTRODUCTION: The published evidence on the association between magnesium sulphate (MgSO4) and delayed passage of meconium (DPM) is contradictory. OBJECTIVES: To determine whether there is an association between the administration of MgSO4 to the mother and DPM in the neonate, and to analyse serum magnesium levels in neonates in relation to the cumulative dose of MgSO4 administered to the mother. POPULATION AND METHODS: Retrospective and prospective descriptive and analytical study conducted in patients delivered at or before 32 weeks of gestation in 2 tertiary care hospitals. Delayed passage of meconium was defined as failure to pass meconium within 48 h of birth and/or need for rectal stimulation on 2 or more occasions to pass stool and/or interval of at least 48 h between the first and second bowel movements. RESULTS: The study included 283 patients (204 retrospectively and 79 prospectively), of who 152 (53.7%) experienced DPM. Delayed passage of meconium was not associated with antenatal MgSO4 administration, the cumulative maternal MgSO4 dose or neonatal serum magnesium levels. Older gestational age (OR, 0.8; confidence interval [CI], 0.69-0.93; P = 0.003) was an independent protective factor against DPM, while the need for advanced resuscitation (OR, 2.24; CI 1.04-4.86; P = 0.04) was a risk factor for DPM. CONCLUSION: The neonatal serum levels of magnesium reached with the doses of MgSO4 administered to mothers were not associated with DPM. Lower gestational age and the need for advanced resuscitation were predictors associated with an increased risk of DPM.

Training, experience and need of booster courses in neonatal cardiopulmonary resuscitation. Survey to pediatricians.

INTRODUCTION: The resuscitation of the newborn in the delivery room requires high capacities and occurs frequently in an unexpected way. Many professionals trained in pediatrics as pediatric residents will work posteriorly in pediatric units with delivery rooms and will perform neonatal resuscitation only occasionally. Skills acquired in practice or resuscitation courses deteriorate over time. MATERIAL AND METHODS: Descriptive observational study through a survey to pediatricians trained in neonatology at a tertiary hospital in Madrid, and who completed their residency period between 2009 and 2016. Questions about their training in resuscitation and their usual work in the delivery room. RESULTS: Out of 179 surveys sent, 140 pediatricians (78,2%) answered it. 73.6% took a training course in neonatal resuscitation during the residency. There was a progressive increase in the number of residents who did the course during the study period. 74.3% have worked after residency in assistance at birth. 40.7% have taken a refresher course in neonatal resuscitation. CONCLUSIONS: Training in neonatal resuscitation has increased and been consolidated during the training process for pediatric residents. A high percentage of pediatricians work after residency in pediatric units with delivery rooms, less than half of these professionals having been recycled in neonatal resuscitation. Recycling and periodic training seem interesting options to improve the performance of these professionals in the delivery room.

Formación, experiencia y necesidad de reciclaje en reanimación neonatal. Encuesta a pediatras / Training, experience and need of booster courses in neonatal cardiopulmonary resuscitation. Survey to pediatricians

Introducción: La reanimación del recién nacido en sala de partos requiere altas capacidades y se produce con frecuencia de manera inesperada. Muchos profesionales formados en pediatría mediante el método de residencia trabajarán a posteriori en unidades pediátricas con paritorio y realizarán reanimación neonatal solo de forma ocasional. Las competencias adquiridas en la práctica o los cursos de reanimación se deterioran con el tiempo. Material y métodos: Estudio descriptivo observacional a través de una encuesta a pediatras formados en Neonatología de un hospital terciario de Madrid y que finalizaron su residencia entre los años 2009 y 2016. Preguntas acerca de su formación en reanimación y su trabajo habitual en paritorio. Resultados: Ciento cuarenta pediatras contestaron la encuesta de 179 encuestas enviadas (78,2%). El 73,6% realizó un curso de formación en reanimación neonatal durante la residencia, objetivándose un incremento progresivo en el número de residentes que lo realizaron durante el período de estudio. El 74,3% ha trabajado tras la residencia en la asistencia al nacimiento. El 40,7% ha realizado algún curso de reciclaje en reanimación neonatal. Conclusiones: Ha aumentado y se ha consolidado la formación en reanimación neonatal durante el proceso de formación de residentes de Pediatría. Un alto porcentaje de pediatras trabajan tras la residencia en Unidades Pediátricas con paritorio, habiéndose reciclado menos de la mitad de esos profesionales en reanimación neonatal. El reciclaje y el entrenamiento periódico parecen opciones interesantes para mejorar la actuación de estos profesionales en sala de partos.(AU)

Introduction: the resuscitation of the newborn in the delivery room requires high capacities and occurs frequently in an unexpected way. Many professionals trained in pediatrics as pediatric residents will work posteriorly in pediatric units with delivery rooms and will perform neonatal resuscitation only occasionally. Skills acquired in practice or resuscitation courses deteriorate over time. Material and methods: descriptive observational study through a survey to pediatricians trained in neonatology at a tertiary hospital in Madrid, and who completed their residency period between 2009 and 2016. Questions about their training in resuscitation and their usual work in the delivery room. Results: Out of 179 surveys sent 140 pediatricians (78,2%) answered it. 73.6% took a training course in neonatal resuscitation during the residency. There was a progressive increase in the number of residents who did the course during the study period. 74.3% have worked after residency in assistance at birth. 40.7% have taken a refresher course in neonatal resuscitation. Conclusions: training in neonatal resuscitation has increased and been consolidated during the training process for pediatric residents. A high percentage of pediatricians work after the residency in pediatric units with delivery rooms, less than half of these professionals having been recycled in neonatal resuscitation. Recycling and periodic training seem interesting options to improve the performance of these professionals in the delivery room. (AU)

SARS-CoV-2 y prematuridad. ¿Existe evidencia de transmisión vertical? / SARS-CoV-2 and prematurity. Any evidence of vertical transmission?

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[Training, experience and need of booster courses in neonatal cardiopulmonary resuscitation. Survey to pediatricians]. / Formación, experiencia y necesidad de reciclaje en reanimación neonatal. Encuesta a pediatras.

INTRODUCTION: the resuscitation of the newborn in the delivery room requires high capacities and occurs frequently in an unexpected way. Many professionals trained in pediatrics as pediatric residents will work posteriorly in pediatric units with delivery rooms and will perform neonatal resuscitation only occasionally. Skills acquired in practice or resuscitation courses deteriorate over time. MATERIAL AND METHODS: descriptive observational study through a survey to pediatricians trained in neonatology at a tertiary hospital in Madrid, and who completed their residency period between 2009 and 2016. Questions about their training in resuscitation and their usual work in the delivery room. RESULTS: Out of 179 surveys sent 140 pediatricians (78,2%) answered it. 73.6% took a training course in neonatal resuscitation during the residency. There was a progressive increase in the number of residents who did the course during the study period. 74.3% have worked after residency in assistance at birth. 40.7% have taken a refresher course in neonatal resuscitation. CONCLUSIONS: training in neonatal resuscitation has increased and been consolidated during the training process for pediatric residents. A high percentage of pediatricians work after the residency in pediatric units with delivery rooms, less than half of these professionals having been recycled in neonatal resuscitation. Recycling and periodic training seem interesting options to improve the performance of these professionals in the delivery room.